2021年全国细菌耐药监测网呼吸科细菌耐药监测报告

Antimicrobial resistance surveillance reports from respiratory medicine departments from China Antimicrobial Resistance Surveillance System in 2021

目的了解2020年10月-2021年9月全国呼吸科感染病原体谱及耐药性特点,掌握耐药流行趋势,为制订抗菌药物的临床应用策略提供依据.方法从全国细菌耐药监测网(CARSS)数据中,用WHONET 5.6软件进行耐药性分析.结果收集呼吸科菌株共计309930株.标本类型分布以痰(75.3%)、肺泡灌洗液(7.3%)和尿液(5.8%)等为主.检出细菌前5位的分别为肺炎克雷伯菌(21.1%)、铜绿假单胞菌(18.1%)、鲍氏不动杆菌(9.3%)、大肠埃希菌(8.5%)和金黄色葡萄球菌(5.5%).药敏数据显示,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为34.2%,甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)的检出率为77.3%,均未发现对万古霉素耐药;碳青霉烯类药物依然是针对本次革兰阴性菌较为有效的药物,但鲍氏不动杆菌除外(耐药率>40%);碳青霉烯类耐药肺炎克雷伯菌和铜绿假单胞菌整体耐药率在9.2%~15.6%,依然需要引起重视;革兰阴性菌出现多重耐药较为常见,其中头孢噻肟或头孢曲松耐药大肠埃希菌、喹诺酮类耐药大肠埃希菌、碳青霉烯类耐药鲍氏不动杆菌的检出率在呼吸科均超过40%.结论我国呼吸科送检标本以痰为主,分离菌以肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌等革兰阴性菌为主,耐药以肠杆菌目细菌最为突出.

OBJECTIVE To understand the spectrum and drug resistance characteristics of pathogens isolated from respiratory medicine department patients with infection from Oct 2020 to Sep 2021 and learn about prevalence trends of drug resistance so as to provide basis for development of strategies for clinical use of antibiotics.METHODS The data were collected from China Antimicrobial Resistance Surveillance System(CARSS),and the drug resistance rates were analyzed by WHONET 5.6 software.RESULTS Among 309930 strains of pathogens that were collected from respiratory medicine department patients,75.3%were isolated from sputum specimens,7.3%were isolated from bronchoalveolar lavage fluid specimens,and 5.8%were isolated from urine specimens.Klebsiella pneumoniae(21.1%),Pseudomonas aeruginosa(18.1%),Acinetobacter baumanni(9.3%),Escherichia coli(8.5%)and Staphylococcus aureus(5.5%)ranked the top 5 species of pathogens.The data of drug susceptibility showed that the isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)was 34.2%,the isolation rate of methicillin-resistant coagulase-negative Staphylococcus(MRCNS)was 77.3%,and no vancomycin-resistant strains were found.Carbapenems remained the effective antibiotics for the gram-negative bacteria except for Acinetobacter baumanni(the drug resistance rate was more than 40%).The drug resistance rates of carbapenem-resistant K.pneumoniae and P.aeruginosa strains ranged between 9.2%and 15.6%,which should be attached great importance to.The multidrug-resistant gram-negative bacteria were more common;the isolation rates of cefotaxime-or ceftriaxone-resistant E.coli,quinolones-resistant E.coli and carbapenem-resistant A.baumannii strains were more than 40%in the respiratory medicine department.CONCLUSION The sputum is dominant among the submitted specimens from the respiratory medicine department patients.K.pneumoniae,P.aeruginosa and A.baumannii are the predominant species of gram-negative bacteria.The drug-resistant Enterobacteriaceae is themost common.